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Are Your Providers Using the MBI?
Starting January 1, 2020, Medicare will only accept claims and eligibility transaction submitted with the Medicare Beneficiary Identifier (MBI). Medicare will reject claims submitted with the Health Insurance Claim Number (HICN), with a few exceptions, and all eligibility transactions. Work with your providers to be sure they are using MBIs for all Medicare business, including claims submission and eligibility transactions, to help protect the identity of people with Medicare. Share the MLN Matters Article about getting and using the MBI.
Eligibility discontinued on CWF
In December 2012, CMS announced plans to discontinue the Common Working File (CWF) beneficiary health insurance eligibility transactions (MLN Matters® Special Edition Article SE1249). In that same article, CMS also announced the HIPAA Eligibility Transaction System (HETS) would be the single source for this data. CMS subsequently delayed this effort based on feedback about the differences in data returned between the two systems and the one-year limit to HETS historical search capability. CMS resolved these issues and is moving forward to phase-out the CWF beneficiary health insurance eligibility transactions. This will address inefficiencies of maintaining two different systems returning the same data.
Beginning in the fall of 2019, CMS plans to terminate access to CWF eligibility queries for those who already utilize HETS. If you currently use both CWF and HETS to get Medicare beneficiary health insurance eligibility information, you should immediately begin to use HETS exclusively.
If you need assistance setting up your HETS access for eligibility inquiries, get started today by contacting your ClaimShuttle Support Team at (602) 439-2525 option 1